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Learn About Your Heart: Welcome
Learn About Your Heart: Articles & Resources

LEARN ABOUT YOUR HEART

Read various articles our doctors have been part of or published themselves.

They are related to things such as cardiac disease, treatment, surgery, heart devices, health tips and more.

Athlete Wiping Face

"From a concerning standpoint, any time people have these types of rhythms their heart rates kind of spike up...They can be sitting around doing nothing and all of a sudden their heart rates go up to 130, 140, 150 beats per minute and that’s unusual for anyone."

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Nikhil Warrier, M.D.

Organic Kale

"This is a fascinating study because it illustrates that by simply eating higher amounts of a natural whole food, it might be possible to make significant changes to our biology and improve our blood pressure."

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Christopher Berg, M.D.

Meds

"Blood pressure has natural swings throughout the day, and this varies for different patients... Knowing when to take your medication may offer a tailored approach to your blood pressure control."

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Hoang Nguyen, M.D.

Coffee Cups

"(With) coffee … there’s just so many unknown variables. We had not that long ago a study that showed that four cups of coffee a day or more was associated with longer survival. I feel like we keep on dragging on coffee. It’s either great, terrible or somewhere in between — it’s probably somewhere in between."

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Yu-Ming Ni, MD

Coffee with Sugar

"I think it goes back to all the other sugar substitutes that have been invented over the years that have had their own issues...So you do ask yourself whether just actually using sugar is better — just limiting the amount."

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Yu-Ming Ni, MD

Blood Test

"PCSK9 inhibitors improve the ability of your liver to take up cholesterol particles from the blood and process them...The result is a significant reduction in cholesterol levels."

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Yu-Ming Ni, MD

Yellow Lentils

"Studies like these remind us that when encouraging patients to avoid animal products high in saturated fat and seek more plant-based options, [we should] also bring up the importance of seeking whole foods and avoid processed packaged foods even if plant-based"

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Jennifer Wong, M.D., FACC

Men Wearing Safety Helmets

"Unless this is clarified in future research, it is uncertain whether low testosterone causes cardiovascular disease and it would be unwise and potentially dangerous to assume that treatment of low testosterone with hormone replacement will reduce heart disease."

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Yu-Ming Ni, MD

Smiling Middle Aged Woman

"Hypertension has previously been shown to be a risk factor for dementia [and] the study nicely shows that with more risk factors, which they calculated with the CAIDE score, there was a higher risk of dementia, even in middle-aged folks."

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Jennifer Wong, M.D., FACC

Doctor and Patient

"We have known for many years that structured exercise improves heart failure outcomes...So it doesn’t surprise me that this medication, with its impact on weight loss, can contribute to a reduction in heart failure symptoms."

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Yu-Ming Ni, MD

Cocktail Party

A new study says drinking alcohol raises heart disease risk — especially for women

"Overall, alcohol can raise blood pressure, which is a risk factor for coronary heart disease, and it may also trigger an inflammatory response...Women in general also seem more sensitive to cardiovascular risk factors"

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Jennifer Wong, M.D., FACC

Working in Office

'The study highlights that every little bit helps...Although this study focused on older, overweight individuals, I think the premise can be applied across the board.'

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Jennifer Wong, M.D., FACC

Plastic Bottles

Measurable microplastics in 60% of studied plaques

"“We just make so much plastic in our environment and to see it degrade and get to a microscopic level and be unable to be further broken down — it’s everywhere...[and] we’re only just starting to scratch the surface as to how that’s going to affect our health certainly from a cardiovascular standpoint."

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Yu-Ming Ni, MD

Active Senior Couple

"The underlying risk factors that increase the likelihood of poor [AFib]-related outcomes can be different between every patient. For example, having a conversation that targets alcohol intake reduction and cessation in a patient for whom this is the primary trigger is different than someone who is sedentary, where starting an exercise program may be the conversation during the visit."

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Nikhil Warrier, M.D.

Herbal Pills

"We've already had problems with niacin, but to see that one of its by-products might be causing cardiovascular harm – I find this to be a really important finding."

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Yu-Ming Ni, MD

Taking a Walk

"I think women get discouraged trying to stay active for a long enough time or trying to get to 10,000 steps...Any steps are better than none"

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Jennifer Wong, M.D., FACC

Skin Screening

"Keep in mind you may have no symptoms at all, nor any of these risk factors, but you might still develop atherosclerosis"

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Science

What Is Homocysteine?

“Homocysteine is an amino acid in the blood,” says Jennifer Wong, M.D., a board-certified cardiologist and medical director of noninvasive cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA.

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Yu-Ming Ni, MD

Healthy Food

"levels of cholesterol in the blood can damage your arteries, raising the risk of heart attack or stroke"

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Illustrated Medical Heart

“We define a silent heart attack as a heart attack that someone didn’t recognize they had,” explains Jennifer Wong, M.D., a board-certified cardiologist and medical director of noninvasive cardiology at Memorial Care Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA.

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Jennifer Wong, M.D., FACC

Sleeping in Green Sheets

"One reason obesity is closely linked with sleep apnea is because of structural changes to your airflow that may occur due to excess weight"

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DNA Strand

“the length of time that these therapies work is longer than any treatment currently on the market. And in the case of the CRISPR [gene-editing] study, it’s potentially lifelong, which is extremely meaningful"

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At the Pediatrician

“It makes sense that blood pressure levels at relatively young ages affect our cardiovascular outcomes later in life"

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Jennifer Wong, M.D., FACC

Walk with a child

"If it’s cold outside, you become vasoconstrictive, so the arteries tighten up and the blood pressure goes higher. If you feel hot, then the blood vessels dilate and you get vasodilation that can cool the body down...”

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Man Doing Blood Test

"these two statins are equally effective at reducing the risk of future [heart-related] events, at least over the short term..."

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Upset Stomach

What Could Be Causing the Pain Under Your Left Breast

"The pain [of Pericarditis] is more typical with certain positions...It can be quite painful."

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Pills

"Some studies have suggested that [Lp(a)] can be attributed to a two to three-times higher risk for heart disease in certain patients at a high Lp(a), so I do think it’s a very important lab test that we should be doing frequently."

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Test Tubes

"Initially, there is plaque buildup in the artery, which causes irritation and then inflammation....The researchers hope the drug saracatinib can stop the process, which will stop the inflammation"

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Vitamins

“ [cardiovascular health] did not demonstrate a significant benefit of vitamin D supplementation, even if there was a trend toward one.”

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Vegan Bowl

"[Eliminating that [Saturated fat] dietary source will naturally reduce dietary cholesterol]. [though] It often goes beyond that"

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Love

"If someone has a history of heart attack, stroke, or cardiovascular disease, and they find statins are not working, they should talk with their doctor about additions or alternatives, such as ezetimibe or bempedoic acid"
 

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Coffee with Sugar

Is the Sweetener Erythritol Safe? Study Links It to Blood Clots and Heart Attack

“We have seen in repeated studies that sugar substitutes have side effects that go beyond simply imitating the taste of sugar,” he says.

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Sleeping in Green Sheets

Irregular sleeping habits may increase atherosclerosis risk

“The authors suggested that disturbance in sleep regularity promotes cardiovascular disease by disturbing the natural circadian rhythm of the body, thereby affecting inflammation, glucose metabolism and sympathetic neurohormal response. All of these factors are known to cause cardiovascular disease.”

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Psychotherapy

Cardiovascular disease: Poor mental health linked to higher risk among young adults

Dr. Ni described “broken-heart syndrome” as a condition that occurs after severe trauma, often before enough time for unhealthy behaviors to take their toll. Most broken-heart patients can be successfully treated.

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Dr. Yu-Ming Ni

Sugaring Croissant

Artificial sweetener associated with heart attack and stroke risk in high-risk patients

To find out for sure,  he recommends that researchers continue to examine the effects of erythritol in larger studies. As for guidance for patients, Dr. Ni suggests physicians drive home the importance of natural, whole foods that don’t rely on artificial sweeteners for a sugary kick.

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Sleeping with Eye Mask

Irregular Sleeping Habits May Increase Risk of Atherosclerosis in Older Adults

“It has been well established that sleep apnea is strongly linked to the development of cardiovascular disease and stroke,” said Dr. Hoang Nguyen, an interventional cardiologist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in California.

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What to Know if Your Doctor Put You on Statins to Lower Cholesterol

“High cholesterol is only one factor in the development of heart disease,” he says. “Others—like smoking, high blood pressure, and diabetes—play a role as well.”

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Why Women May Actually Have a Higher Risk of Developing AFib

“In AFib, the atria, or upper chambers of the heart, beat in an extremely disorganized way (sometimes up to 300 to 600 beats per minute). This leads to an increased risk of stroke and congestive heart failure,” Warrier explained to Healthline.

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Scientist with Microscope

Study: HDL Cholesterol May Not Be That Good at Reducing Your Risk of Heart Disease

Dr. Ni says that the study is “useful” for understanding cardiovascular risk in different patients, but stresses that “treating the whole picture is often more beneficial.”

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“In general, our emotional and mental health is closely bound to our physical health,” says Dr. Sarah Elsayed. "The COVID-19 pandemic for example, has shown us an increase in patients diagnosed with hypertension, palpitations and shortness of breath."

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Sarah Elsayed, M.D.

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...Since this is a comparatively newer diagnosis versus “cardiac conditions such as hypertension and coronary artery disease,” providers often misunderstand it. says Hoang Nguyen, MD.

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Hoang Nguyen, M.D.

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Inflammation from the flu can cause plaques, cholesterol, fatty substances, waste products, and calcium, in the wall of your arteries to rupture, leading to blockages and heart attacks, Dr. Wong says.

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Jennifer Wong, M.D., FACC

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Nikhil Warrier, MD, cardiac electrophysiologist and medical director of electrophysiology at Memorial Care Heart & Vascular Institute at Orange Coast Medical Center, tells what are heart palpitations? | Heart palpitations symptoms | Heart palpitations causes | Heart palpitations triggers | When to worry about heart palpitations | When to see a doctor | Heart palpitations treatment and prevention

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Nikhil Warrier, M.D.

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“(It’s) the most common irregular heartbeat in athletes,” Warrier said. “With A-Fib, palpitations is the most common symptom. The other symptom could be fatigue or exhaustion and not be able to perform at the level he’s used to performing it.”

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Nikhil Warrier, M.D.

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"A study showed that people with type A or B blood were 51% more likely to develop blood clots in the veins and 47% more likely to develop blood clots in the lungs," says Leann Poston. "Specifically, type A blood puts you at 6% higher risk of heart disease; Type B with a 15% higher risk; and Type AB puts one at 23% higher risk," says Hoang P Nguyen, MemorialCare.

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Hoang Nguyen, M.D.

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“These findings are similar to prior studies with older adults. However, this is an observational study and thus does not prove causation,” she says. 

Doctor: Dr. Jennifer Wong, M.D.

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Jennifer Wong, M.D., FACC

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Coronary artery disease is caused by plaque buildup in the arteries of the heart in a process called atherosclerosis, which can start in one’s teens and 20s,” says Jennifer Wong, M.D.

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Jennifer Wong, M.D., FACC

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People with a blood pressure range of 90 to 120 systolic and 60 to 80 diastolic have normal blood pressure, says Dr. Wong. A systolic reading below 90 signifies low blood pressure.

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Jennifer Wong, M.D., FACC

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[Dr. Wong] points out that studies are needed to look into the effects of treating women at a lower blood pressure threshold before this would become common practice.

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Jennifer Wong, M.D., FACC

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But Dr. Patel urges people not to take the potential risks lightly that are associated with having a daily aspirin. "Even though this is an over-the-counter medication, it can cause serious side effects," he says. "The longer you take it, the more risk that you will have these side effects."

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Sanjiv Patel, M.D.

Elder woman and her caretaker

"There are a few different ways heart disease can cause low blood pressure, depending on which type of heart condition you may be experiencing"

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Christopher Berg, M.D.

Aerial Yoga with Teacher

"This is not really surprising...We’ve known for a very long time that statins prevent heart disease. They’re especially effective for patients who already have heart disease to prevent a recurrent event"

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Yu-Ming Ni, MD

Family Dinner

"Having a very high cholesterol can indicate a genetic predisposition for heart disease. In that case, your risk for heart disease is increased 20-fold"

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Yu-Ming Ni, MD

Strawberry Ice Cream

"However, all 10 patients who had erythritol had an increase in these platelet activity factors...I personally am not using erythritol anymore"

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Yu-Ming Ni, MD

Confident Senior Portrait

"There [are] many different conditions that diabetes affects.. So the findings of the study are not surprising to me. It more just highlights how significant long-standing exposure to diabetes can affect your health in so many different ways."

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Yu-Ming Ni, MD

Lone Walk

"I think the key point is that it’s not just loneliness that likely contributes to the risk of stroke. It’s a combination of factors. The fact that you’re lonely most likely means that you’re less able to care for yourself."

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Yu-Ming Ni, MD

Cleaning Windows

"It is noted that many patients developed at least low-level heart injury, as measured by troponin levels, and that cardiovascular symptoms took longer than other symptoms to recover from"

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Yu-Ming Ni, MD

Friendly Doctor

"I have noticed that most patients with statin intolerance are women...This might explain less ongoing treatment with statins, but it wouldn’t explain the disparity in initial prescriptions for them.

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Yu-Ming Ni, MD

Picnic in Park

"Age, structural heart disease (prior MI, heart failure or valvular heart disease), hypertension, obesity, excessive caffeine/alcohol intake, stress from lifestyle/surgeries/infection, thyroid disease, sleep apnea are some of the risk factors for the development of AFib. Focusing on identifying and modifying any of these risk factors can lead to decreased risk of development of AFib. They are also a core pillar in our treatment of AFib in patients who already have AFib."

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Nikhil Warrier, M.D.

Upset Stomach

"We coexist with trillions of organisms on our skin and in our intestinal and genitourinary tract. These organisms play a critical role in our ability to fight off external pathogens, in the metabolism of food, and in the health of our immune system. Specifically, this study shows that there are bacterial strains that may affect cholesterol exposure in the intestinal tract."

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Yu-Ming Ni, MD

Shoulder Stretch

"I suspect that many patients in this study who were eating [for fewer] than 8 hours per day were doing so not because they were trying to lose weight. I suspect that they had a problem of some kind that they only ate for that long"

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Yu-Ming Ni, MD

Scattered Pills

Niacin flush: Causes, treatment, and prevention

"it is especially pronounced in warm temperatures or when exercising, and that he has had several patients faint in the shower while taking niacin due to low blood pressure."

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Yu-Ming Ni, MD

Running Shoes

"It allows us to back up what we say about the importance of physical activity, even in relatively low levels"

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Jennifer Wong, M.D., FACC

Pressure point massage 2

"Ironically, blood pressure readings in the physician’s office are often inaccurate; falsely elevated due to the stress of being in the physician’s office or the stress of getting there,” he explained"

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Hoang Nguyen, M.D.

Diet Salad

"The most important thing you can do is eat a heart-healthy diet and exercise"

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Jennifer Wong, M.D., FACC

Running Gear

"a systematic review of almost 200 interventional studies shows all types of exercise decreased resting heart rates"

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Nikhil Warrier, M.D.

Romantic Couple

Taking Meds for Both Chest Pain and Erectile Dysfunction Linked to Heart Failure Risk

It could be that the increased risk of negative health outcomes is due to both types of medications causing dilation of the blood vessels, said Dr. Yu-Ming Ni, cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, Calif.

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Yu-Ming Ni, MD

White Pills

"Hormone replacement therapy has long been known to increase the risk of blood clots, which for most people may not be clinically significant, but occasionally will lead to serious consequences"

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Jennifer Wong, M.D., FACC

Red Pills

"Statins are medications that reduce the amount of cholesterol your body makes in the liver. In doing so, our liver responds by taking up cholesterol particles in the blood more readily, resulting in less cholesterol in the blood available to damage arteries and cause a heart attack or stroke"

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Prepared Meals

“The portfolio diet is a specialized dietary pattern aimed at reducing ‘bad’ LDL cholesterol, a key risk factor for heart disease and stroke..."

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Jessica Schachter, DO

Hummous with Pita Bread

“I think there’s some subtle differences in cholesterol. I just don’t think that it’s going to be just because one study says that maybe there isn’t a difference depending on adherence, I wouldn’t say that you shouldn’t do Mediterranean diet anymore.”

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Reminiscing

“There’s obviously a lot of different kinds of lipids out there that all can influence cardiovascular disease...We know that cholesterol is probably the number one risk factor for cardiovascular disease"

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Family

"At a minimum, do what you can to find out if anyone in your biological nuclear family—meaning, your parents and siblings by birth—had or has heart issues"

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Calculator and Finances

Risk Reduction Program Helps Lower Chance of Heart Attack and Stroke

“If you’re going to intensely manage somebody you want to prevent problems, and therefore it should cost you less over time…I would have expected it to be a lot more than 0.4%.”

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Walking in Nature

"People who are sedentary tend to gain weight and we know that fat is generally more inflammatory, leads to more issues with insulin resistance, which can also lead to diabetes and leads to higher blood pressure, a lot of issues related to the weight gain,”

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Pills

"I agree with the study’s notion of how important aspirin is for people who have had a heart attack. We often assume that something is true based on our observation. This study gives us a clear answer. We now know that aspirin significantly reduces that risk for people at elevated risk of having subsequent heart events."

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Man and Woman Running

“Chest pain is still the most common presentation on both men and women, but women tend to have more of the atypical symptoms such as pain in a different location, shortness of breath, or fatigue.”

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Jennifer Wong, M.D., FACC

Fixing Electricity Lines

"It speaks to the stress of the upcoming work week; we know that stress can correlate to challenges [such as] destabilizing plaque in the arteries" 

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Shattered

"An EKG guides us in the treatment of these heart rhythm problems, and they can detect when our treatment is effective—or potentially harmful, requiring switching of medication."

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Doctor's Visit

“In patients with a history of coronary artery disease who are not candidates for bypass surgery or stents, beta blockers are essential to reduce symptoms of angina (chest pain) and hospitalizations for this symptom. But, if they have been re-vascularized (either by stents or bypass surgery) or have normal left ventricle function, I may attempt to wean off beta blockers, especially if they have significant side effects.”

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Hoang Nguyen, M.D.

Latte Art

Can regular coffee consumption help lower blood pressure?

“Those drinking 2 cups of coffee had 5-point lower blood pressure on average than those who didn’t drink coffee. The effect was higher for those drinking more than 3 cups of coffee, with a 9-point lower blood pressure on average compared to those who didn’t drink coffee. This trend towards lower blood pressure with more coffee consumption persisted for different types of blood pressure measurements, including an estimate of a more reliable blood pressure measurement called central blood pressure."

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Breathe

How Asthma and Heart Disease Are Connected—and What to Do About It

“Asthma causes an inflammatory process in the airways, and inflammation is a known exacerbator of cardiovascular disease,” explains Jennifer Wong, M.D.

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Sweetening Coffee

Hypertension: Can regular coffee consumption help lower blood pressure?
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“Those drinking 2 cups of coffee had 5-point lower blood pressure on average than those who didn’t drink coffee. The effect was higher for those drinking more than 3 cups of coffee, with a 9-point lower blood pressure on average compared to those who didn’t drink coffee. 

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Squash Player

Cardiac Arrest Risk Low for Active Seniors During Sports

Warrier agrees that the overall benefits of sports activity likely outweigh the low risk of sudden cardiac arrest. That said, "always talk with your provider if you experience any symptoms during physical activity, as part of an assessment of your individual risk for sports-related sudden cardiac arrest," he cautions. 

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Another common disease, liver failure—which affects some 4.5 million Americans, reports the CDC—can also cause swelling or water retention when "the liver [fails] to produce vital protein such as albumin," says Dr. Nguyen.

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Hoang Nguyen, M.D.

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"[D]iseases happen due to previous conditions that add up to a heart attack or a stroke, and are not typically due to random events," says Dr. Yang. “By being active, in general, you can burn more calories, lose weight, get muscle tone, feel better in your mind,” says Sanjiv Patel, MD

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Dr. Yang and Dr. Patel, M.D.

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The most common reason you might have to check your blood pressure at home is that some people experience "white coat syndrome," where their blood pressure is significantly higher in the doctor's office than it is at home, says Hoang Nguyen, MD.

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Hoang Nguyen, M.D.

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Vegetables have more monounsaturated fats and polyunsaturated fats, which can lower your levels of LDL cholesterol and raise the amount of HDL (good) cholesterol in your body, Dr. Wong says. As a result, it can decrease your stroke risk.

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Jennifer Wong, M.D., FACC

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“I think for younger patients, it could be an element of noncompliance: not going to doctors, not taking medications — […] especially young men," Wong stated. Moreover, Dr. Wong said, young patients often do not tolerate beta-blockers, a common blood pressure-lowering medication.

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Jennifer Wong, M.D., FACC

Image by Akshar Dave 🍉

Dr. Warrier recalled a January 2021 letter to Heart Rhythm, describing “a potential interaction between defibrillators and the iPhone 12, where the iPhone 12 is close by, to disable therapies.”

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Nikhil Warrier, M.D.

Image by Mr Cup / Fabien Barral

Nikhil Warrier, MD, cardiac electrophysiologist and medical director of electrophysiology at Memorial Care Heart & Vascular Institute at Orange Coast Medical Center, tells Verywell that previous research does support this relationship between stress and cardiovascular issues. 

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Nikhil Warrier, M.D.

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Dr. Nikhil Warrier, the medical director of electrophysiology at Orange Coast Medical Center in Fountain Valley, said the procedure “is an attractive option for closure or litigation in patients who are at high risk for stroke and not ideal candidates for long-term blood thinners.”

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Nikhil Warrier, M.D.

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“This is a very small percentage of [a specific group of] people who are reported to have this,” Dr. Wong says. It’s also important to take the risk-benefit ratio into account. The benefits of getting vaccinated so far outweigh the possibility of this rare condition, she says, if a cause-and-effect relationship is confirmed at all.

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Jennifer Wong, M.D., FACC

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Moderately high blood pressure: Exercise should be first-line treatment

“We encourage [people],” said Dr. Wong, “to make small changes — small increases in physical activity like walking down that hallway instead of calling up your colleague.”

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Jennifer Wong, M.D., FACC

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“Red meat consumption has been associated with an increased risk of heart disease as well as cancer and Type 2 diabetes,” says Jennifer Wong, MD

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Jennifer Wong, M.D., FACC

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 "You may see stories of young athletes who collapse on the court or field and die—some of them have hypertrophic cardiomyopathy." Dr. Nguyen says that not everyone who has the condition will die suddenly. But, he adds, "the risk is there."

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Hoang P Nguyen, M.D.

Skin Care

"In addition to causing itching, these cytokines... small proteins that play key roles in regulating the activity of immune cells — signal a cell’s nucleus to create more cytokines like themselves, resulting in spiraling inflammation, and thus more itching and more cytokines."

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Hoang Nguyen, M.D.

Headache

"It is useful to have studies like this and it makes sense that simplifying the medication might really have better outcomes. Hypertension is something that many people can’t feel when they have it and that leads to serious consequences"

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Jennifer Wong, M.D., FACC

Prescription Medicine

"Statins help prevent heart disease... If you stop taking statins, your risk for heart disease will go up"

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Yu-Ming Ni, MD

Standing Desk

"I talk to my patients about this [enacting health behaviors all of the time" 

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Yu-Ming Ni, MD

Marinated Olives

"Studies like these that look at both plant-based diet and the amount of oil — whether it’s monounsaturated healthy oils like olive oil or saturated fat — really help highlight the immediate metabolic effects that we see when people are randomized to healthier options"

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Jennifer Wong, M.D., FACC

Coffee and Magazines

"But when you’re looking at associations, it’s hard to know whether the coffee is the reason for why the reduction in heart disease is occurring or if there’s some other factor that that person that’s drinking coffee is doing that reduces their cardiovascular mortality. So that’s probably the most important takeaway from this."

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Yu-Ming Ni, MD

Woman Climber

“I think it reiterates the importance of exercise, maybe not necessarily this extreme level of exercise, but just any exercise being helpful for one’s cardiovascular health and ultimately, hopefully extending one’s life that way.”

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Jennifer Wong, M.D., FACC